Effect of different cryosurgical protocols using liquid nitrogen on bone tissue: a histomorphological analyze

The aim of the present experimental study was to evaluate the morphological effects of different liquid nitrogen cryosurgery protocols on bone tissue. The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphologically. Histologically, an increase in bone necrosis was observed for the two protocols in the second week after cryotherapy. A significant osteogenic phase was observed after 4 weeks. Moreover, complete remodeling process was encountered at the end of the morphological observation period (12 weeks), especially on oneminute protocol. Thus, this study indicated that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. In addition, the second experimental week was critical for bone necrosis with either cryotherapy protocol. Further studies are important for the understanding of the long-term behavior of bone tissue after cryoapplication of liquid nitroge

Oral lipomas in a Brazilian population : a 10-year study and analysis of 450 cases reported in the literature

Objectives: Lipomas are common benign mesenchymal neoplasms that rarely occur in the oral cavity and correspond to less than 4.4% of all benign oral soft tissue tumors. This study describes the clinical, radiological and histological features of cases of oral lipomas seen over a period of 10 years and compared the findings with those reported in the literature. Study Design: All cases of oral lipomas seen between 1999 and 2009 were retrieved from the archives of the Stomatology Division of the Federal University of Ceará, Brazil. Age, gender, tumor location, clinical findings, duration, histological subtypes, and treatment outcome were recorded. In addition, the English-language literature was searched for studies published between 1966 and 2009. Results: Ten patients (6 women and 4 men) were enrolled in this study. The mean age was 53.4 years (range: 21-73 years). The specific sites involved were the oral mucosa (n=5), vestibule (n=3), gingiva (n=1), and retromolar region (n=1). The mean size of the tumors was 1.94 cm (range 1.0 to 3.0 cm). Radiographically, only one case appeared as a radiolucent area on occlusal film. Microscopically, 4 cases were classified as simple lipoma, 4 as fibrolipoma, 1 as myxoid lipoma, and 1 as angiolipoma. The duration of the tumors ranged from 2 to 84 months, with a mean duration of 30.4 months. All cases were treated by simple surgical excision and there was no recurrence after a mean post-treatment period of 34.5 months. The findings were compared with 450 cases of oral lipomas reported in the literature. Conclusions: Lipomas continue to be an uncommon neoplasm of the oral cavity. Radiography is a valuable tool due to the possible occurrence of bone involvement. Surgical excision is the treatment of choice and recurrence is not expected

Do third molars weaken the mandibular angle?

Objective: The purpose of this study is to estimate how is the magnitude of the impact of a mandibular third molar on the mandibular angle stiffness. Study Design: It was performed a literature search on whole MEDLINE and LILACS data base to find articles that match the following inclusion criteria: cohort studies presenting data on patients with mandibular fractures and third molars; that had a similar angle fracture definition; and that present data available to be cross-classified in a statistic analysis. Results: The sample was composed by 4 studies, involving 2533 patients from USA, Nigeria, Germany and Jordan, evaluated between 1976 and 2001. The analysis of the sample shows a relative risk for a mandibula to fracture, comparing patients with and without third molars, ranging from 1,18 to 2,25. The data of the sample was grouped because of the homogeneity of the articles methods. The estimated relative risk across the 4 studies was 1,94 (95% CI 1,6 - 2,35). Conclusions: The presence of a third molar may double the risk of an angle fracture of the mandible to occur. Even with this data, the present study cannot support conditions related to the third molar that may affect this impact. Further studies are necessary to discuss the true indication of removal of these teeth as a prophylactic measure in population groups more predisposed to fracture. © Medicina Oral

Gingival calcifying epithelial odontogenic tumor: case report and review of the literature comprising a period of 44 years

Calcifying epithelial odontogenic tumors are rare odontogenic neoplasms that account for approximately 1% of all odontogenic tumors. The extraosseous variant is extremely rare, with only few cases being described in the literature. To our knowledge, only 22 cases have been reported over a period of 44 years. Therefore, the aim of this study was to present a critical literature review comprising the period from 1966 to 2010. In addition, we discuss the clinical presentation, diagnosis, and subsequent treatment of a patient with a gingival calcifying epithelial odontogenic tumor in the anterior mandible. This study shows that even though being an extremely rare neoplasm the gingival calcifying epithelial odontogenic tumor should be included in the differential diagnosis by general dentists of gingival lesions due to its clinical similarity to other oral hyperplastic or reactive lesions. A conservative surgical approach can be adopted in view of the nonaggressive behavior of this tumor. Recurrence is low and the prognosis is excellen

ALTERAÇÕES DENTOMAXILOFACIAIS EM INDIVÍDUOS ACOMETIDOS PELA SÍNDROME 49XXXXY: REVISÃO DE LITERATURA

A síndrome 49, XXXXY é uma aneuploidia cromossômica sexual rara, que acomete homens e causa déficits nos domínios motor, de linguagem e cognitivo, sendo muito comum também o desenvolvimento de anomalias dentárias ao longo da vida. Dessa forma, objetiva-se revisar a literatura acerca dos aspectos orais da síndrome 49 XXXXY. Foram realizadas buscas nas bases de dados PubMed e Google Acadêmico, utilizando as seguintes palavras chaves: “49XXXXY”, “dentistry”, “teeth anomalies”, em associação. Foram selecionados títulos que relacionassem os três fatores, resultando num total de 6 artigos. Após leitura criteriosa dos resumos, foram excluídos artigos que fugiam ao tema, por fim, 5 artigos foram incluídos nesta revisão. Entre os aspectos orais mais comuns todos os estudos evidenciaram cárie, enquanto mais da metade observou taurodontia e má higiene, além de 40% observarem má oclusão, ausências dentárias, mordida cruzada, hipodontia e prognatismo mandibular em pacientes com a síndrome. Os trabalhos mencionaram achados mais raros como micrognatia madibular, atraso na dentição, defeitos de esmalte, dentes ectópicos, boca seca, palato ogival e incisivos laterais conoides. A síndrome 49, XXXXY é uma condição rara que apresenta significativas alterações dentárias, dessa forma pacientes portadores necessitam de uma abordagem interdisciplinar, na qual a avaliação odontológica é uma etapa de grande importância para o tratamento reabilitador desses indivíduos, fomentando qualidade de vida a eles

A eficácia da fibrina rica em plaquetas em exodontias de terceiros molares inferiores: uma revisão da literatura / The efficacy of fibrin-rich platelets in extractions of lower third molars: a literature review

Introdução: A remoção dos terceiros molares mandibulares é um dos procedimentos cirúrgicos mais comumente realizados na Odontologia, entretanto, é frequentemente acompanhada por complicações, sendo a dor, trismo e edema as mais comumente relatadas. Nesse contexto, a Fibrina Rica em Plaquetas (PRF), tem sido utilizada em diversos procedimentos cirúrgicos devido aos seus benefícios ne redução da morbidade pós operatória. Apresenta-se como uma das alternativas mais promissoras de fonte autóloga de citocinas e fatores de crescimento capazes de favorecer a regeneração tecidual. Objetivo: Revisar e discutir a literatura acerca do uso e da eficácia da PRF em exodontias de terceiros molares inferiores.  Metodologia: Foi realizado um levantamento bibliográfico mediante consulta às bases de dados PubMed, Web of Science, Scopus e Lilacs no período de outubro à novembro de 2020. Foram utilizados os seguintes descritores em conjunto: “platelet-rich fibrin”, “third molar” e “surgery”. A seleção dos artigos baseou-se no ano de publicação, restringindo-se aos últimos dez anos (2010 à 2020), ao idioma inglês, e aqueles em que o texto completo estava disponível. Foram selecionados os artigos que envolviam estudos de casos clínicos randomizados e revisões sistemáticas com e sem meta-análise acerca do uso da PRF após exodontias de terceiros molares inferiores. Foram excluídos os artigos que não se relacionavam ao tema proposto, além de revisões de literatura, artigos de opinião e relato de caso. Por fim, 24 artigos foram selecionados para a realização desta revisão de literatura. Resultados: Em relação a variante dor, 11 (45,8%) artigos mostraram em seus estudos diferenças significativamente estatísticas, 4 (16,6%) artigos não apresentaram diferenças e 9 (37,5%) artigos não relataram. Na variante edema, 10 (41,6%) artigos mostraram diferenças significativamente estatísticas; 3 (12,5%) artigos não apresentaram diferenças e 11 (45,8%) artigos não relataram. Na variante trismo, 1 (4,1%) artigo mostrou diferença significativamente estatística, 5 (20,8%) artigos não apresentaram diferenças e 18 (75%) artigos não relataram. Na variante reparo de tecido mole, 7 (29,1%) artigos mostraram diferenças significativamente estatísticas, 5 (20,8%) artigos não apresentaram diferenças e 12 (50%) não relataram. Por último, na variante reparo ósseo, 5 (20,8%) artigos mostraram diferenças significativamente estatísticas, 7 (29,1%) não apresentaram diferenças e 12 (50%) não relataram. Conclusão: Dessa forma, podemos observar que há a necessidade de mais estudos a fim de se obter resultados conclusivos sobre a real eficácia da PRF em exodontias de terceiros molares inferiores. 

Oral granular cell tumor: a study of twelve cases in a Brazilian population

Objectives: Analyze clinic and epidemiological aspects of all Oral Granular cell tumor (GCT) during a 5-year period in a Brazilian population. Study design: clinical and treatment outcome data of patients with oral GCT seen at the Division of Stomatology, School of Dentistry, Federal University of Ceara, Brazil, between January 2001 and December 2005 were reviewed. Results: during the analyzed period, 6231 oral lesions were collected from files of different anatomo-pathology laboratories situated in the state of Ceara, Brazil. Of all cases, only 12 of GCT were diagnosed. The lesion was more common in female patients, with a mean age of 40.8 years, occurring mainly in tongue. Conclusion: Oral GCT is a rare and infrequent lesion in this population, and affects more female in the third, fourth a fifth decade of life. Clinical significance: Although it is a rare occurrence in the oral cavity, the clinician must know about its occurrence and should include GCT in the differential diagnose of certain lesions especially when situated in tongu